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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two children with the short-gut syndrome and secondary liver failure were treated with evisceration and transplantation en bloc of the stomach, small intestine, colon, pancreas, and liver. The first patient died perioperatively, but the second lived for more than 6 months before dying of an Epstein-Barr virus-associated lymphoproliferative disorder that caused biliary obstruction and lethal sepsis. There was never evidence of graft rejection or of graft-vs-host disease in the long-surviving child. The constituent organs of the homograft functioned and maintained their morphological integrity throughout the 193 days of survival.
JAMA 1989 Mar 10
PMID:Transplantation of multiple abdominal viscera. 291 40

We prospectively studied the safety of replacing intravenous delivery systems, including those used in total parenteral nutrition, at 72- compared with 48-hour intervals in 487 patients. Although the prevalence of contamination of intravenous fluid was higher in administration sets replaced at 72-hour intervals (10/664, 1.5%) than in sets replaced every 48 hours (6/710, 0.8%), the difference is not statistically significant. Contamination in both groups was almost exclusively with small numbers of coagulase-negative staphylococci (range, 1 to 27 colony-forming units/mL); no contaminated infusion was associated with clinical signs of sepsis or concordant bacteremia. Contaminants were recovered less frequently from peripheral venous infusions (0.6%) than from infusions used for central venous access or hemodynamic monitoring (1.5%) or total parenteral nutrition (3.6%); infusions in an intensive care unit were more frequently contaminated (2.5%) than infusions on medical and surgical wards (0.9%). These data indicate that extrinsic contamination of intravenous fluid is a rare cause of endemic nosocomial septicemia, and for most infusions it is unnecessary to routinely replace delivery systems more frequently than every 72 hours.
JAMA 1987 Oct 02
PMID:Prospective study of replacing administration sets for intravenous therapy at 48- vs 72-hour intervals. 72 hours is safe and cost-effective. 311 6

A review of 399 resuscitation efforts in 329 patients within one year at the Houston Veterans Administration Medical Center indicated that an age of 70 years or greater is associated with poor outcome after in-hospital cardiopulmonary resuscitation (CPR). Basing their conclusions on a detailed analysis of the methods and results of their study, the authors argue that CPR should be reserved for those who have a reasonable chance of survival until discharge, while admitting that the definition of this standard will vary. They recommend that patients 70 years or older, and patients with cancer or sepsis, should be identified as candidates for CPR only after considerable reflection by families and clinicians.
JAMA 1988 Oct 14
PMID:In-hospital cardiopulmonary resuscitation. 291 48

We analyzed 24,584 cultures obtained from 3371 infants during a three-year period to determine how frequently body surface culture isolates matched those obtained subsequently from body fluids. The sensitivity, specificity, and predictive values of surface cultures were calculated daily for the two weeks up to and including the day that a body fluid culture was obtained. Isolates from cultures of material from the ear canal, nasopharynx, axilla, umbilicus, groin, rectum, stomach, and endotracheal tube were rarely the same as those recovered from blood or fluids of the cerebrospinal, joint, pleural, pericardial, and peritoneal spaces. With a frequency of sepsis of 3.3% among patients in our neonatal intensive care unit, the optimum sensitivity, specificity, and positive predictive values of surface cultures were 56%, 82%, and 7.5%, respectively. These values did not improve substantially for any specific times of surface cultures prior to sepsis, for anatomic sites cultured, or for pathogens recovered. We conclude that surface cultures are of limited value in predicting the etiology of sepsis in neonates.
JAMA 1988 Jan 08
PMID:Sensitivity, specificity, and predictive value of body surface cultures in a neonatal intensive care unit. 327 12

Epiglottitis in pediatric patients is an infection caused by Haemophilus influenzae type b, which can lead rapidly to sepsis and an asphyxial death. In an effort to study the cause and clinical course of adult epiglottitis, eight serially hospitalized adult patients with supraglottitis over a ten-month period were prospectively evaluated, including a daily laryngeal examination. Although multiple anatomic sites in the larynx and oropharynx were inflamed, the epiglottis was often not the most involved area and was actually normal in one patient. Bacterial cultures were harvested from blood, the nasopharynx, the oropharynx, and the vallecula in all patients and the preepiglottic space in two patients. In no case was H influenzae demonstrated. No patient developed respiratory compromise. It was concluded that epiglottitis is an inaccurate description of this disorder and that this non-H influenzae adult variety of supraglottitis seemingly can follow a less pernicious course than the classically described infection.
JAMA
PMID:Adult supraglottitis. A prospective analysis. 333 78

This article describes the infectious complications that occurred among four of the longest-term recipients of the Jarvik-7 artificial heart. Infection arising from the drive lines, with spread to the mediastinal periprosthetic space, was the major limiting factor in long-term use of the device in these patients. Periprosthetic infections were due to coagulase-negative staphylococci, Staphylococcus aureus, Pseudomonas aeruginosa, and other Pseudomonas species. Other infectious complications incurred by some of the patients included pneumonia, empyema, urinary tract infection, and intravascular line sepsis with Candida. Intensive antimicrobial therapy for prolonged periods seemed to suppress but not to eradicate infection and was accompanied by the appearance of multiresistant bacterial strains. Complications of antimicrobial therapy included diarrhea secondary to overgrowth with Clostridium difficile in two patients. Use of the current device for more than 30 days should be considered extraordinary and should be reserved for patients for whom no other form of life support is available.
JAMA 1988 Feb 12
PMID:Infectious complications in four long-term recipients of the Jarvik-7 artificial heart. 333 99

In 1986, the Centers for Disease Control, in collaboration with the Health Care Financing Administration, surveyed 1350 chronic hemodialysis centers in the United States to ascertain practices associated with the reuse of disposable hemodialyzers and the frequency of pyrogenic reactions and septicemia among patients. Reuse of hemodialyzers was reported by 63% of the centers. Centers that used RenNew-D (n = 5) for reprocessing hemodialyzers, compared with centers that did not reuse (n = 495), were more likely to report pyrogenic reactions (60% vs 13%) and episodes of septicemia (100% vs 55%) among their patients. Reusing hemodialyzers more than 20 times and, in some instances, also using manual reprocessing systems was significantly associated with clustering of pyrogenic reactions regardless of the type of germicide used. To detect membrane leaks developing after multiple reuses, air-pressure-leak tests should be performed on all reprocessed hemodialyzers.
JAMA 1988 Oct 14
PMID:Reuse of hemodialyzers. Results of nationwide surveillance for adverse effects. 341 71

In early 1983, an outbreak of illness caused by raw milk contaminated with multiple-antimicrobial-resistant Salmonella typhimurium occurred in Arizona. One of the cases involved a 72-year-old woman who died with Salmonella enteritis and sepsis that had not responded to treatment with chloramphenicol. The S typhimurium isolates from this patient, from other ill persons, and from raw milk were resistant to ampicillin, chloramphenicol, kanamycin sulfate, streptomycin, sulfonamide, and tetracycline. These resistances were mediated by a 105-megadalton R plasmid. During the epidemic period, 43% of the S typhimurium isolates submitted to the Arizona Department of Health Services were resistant to chloramphenicol, and 80% of these possessed the same plasmid resistance. Although there was evidence of spread of the S typhimurium in the community, there was no evidence of spread of this Salmonella R plasmid to the normal flora of patients or their family members a median of 14 weeks after the infection. This outbreak demonstrates the ability of drug-resistant Salmonella to spread from the animal to the human reservoir and, in a suitable host, produce a fatal infection.
JAMA 1985 Apr 12
PMID:An outbreak of multiple-drug-resistant Salmonella enteritis from raw milk. 388 21

To identify risk factors for Vibrio vulnificus infections, we performed a regional case-control study of 19 patients identified by isolates received at a state reference laboratory. Interviews with patients or surviving relatives and with three controls for each patient were compared in a matched analysis. Patients with V vulnificus wound infection were more likely than controls to have sustained a puncture wound while handling fresh seafood or to have been exposed to salt water. More patients with primary septicemia than controls had eaten raw oysters before the onset of illness. Other risk factors for septicemia included underlying liver disease, hematopoietic disorders, chronic renal insufficiency, use of immunosuppressive agents, and heavy alcohol consumption. Although V vulnificus infection is unusual, with a regional incidence of 0.8 per 100,000 population in this study, septicemia in the immunosuppressed patient is a devastating illness that can be prevented by not eating raw seafood.
JAMA 1985 May 17
PMID:Vibrio vulnificus. Man and the sea. 398 59

Fifteen anorectal infections occurred in 6.4% of 188 intensively treated patients with small cell bronchogenic carcinoma. Granulocytopenia was present at onset in 13 episodes. In eight episodes, perirectal pain preceded any objective findings by two to 11 days. Ten infections resolved with recovery from granulocytopenia, but the five abscesses required incision. Septicemia accompanied four episodes; one patient died. Early recognition and therapy of this potentially fatal infection will become increasingly important as more patients with solid tumors receive intensive therapy.
JAMA 1981 Nov 27
PMID:Perirectal infections in patients with small cell lung cancer. 627 92


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